Deadline: December 3, 2015 (One hard copy and one PDF on CD) Primary Contractor Project Name _________________________________________________ Name ___________________________________ _________________________________________________ Title Project Completion Date _________________________________________________ Agency/Organization Must be substantially completed (90%) and available for public use as of December 31, 2015. _______________________________________________ _________________________________________________ Address (if post office box, include street address) Public Agency __________________________________________ ___________________________________ __________________________________________ City State/Province Phone Zip/Postal Code Fax Project Category Structures Transportation Environment Historical Restoration/Preservation Disaster or Emergency Construction/Repair Project Division Less than $5 Million $5 Million, but less than $25 Million $25 Million - $75 Million More than $75 Million __________________________________________ Name __________________________________________ Title __________________________________________ Agency/Organization __________________________________________ Address (if post office box, include street address) __________________________________________ State/Province Zip/Postal Code __________________________________________ Phone Fax __________________________________________ E-mail E-mail Primary Consultant _________________________________________________ Name _________________________________________________ Title _________________________________________________ Agency/Organization Managing Agency City __________________________________________ _________________________________________________ Address (if post office box, include street address) _________________________________________________ City State/Providence Zip/Postal Code _________________________________________________ Phone Fax _________________________________________________ Email Continued…. Please address each of the following areas in your nomination, adhering to the sequence below when possible. Completion date contained in contract. Any time extensions granted should be addressed in the submittal. Construction schedule, management, and control techniques used. Use of alternative materials, practices of funding that demonstrates a commitment to sustainability. Safety performance including number of lost-time injuries per 1,000 man-hours worked and overall safety program employed during the construction phase. Environmental considerations including special steps taken to preserve and protect the environment, endangered species, etc., during the construction phase. Nominated by: (can only be nominated by managing public agency or APWA chapters.) Projects that involve or reside within two or more chapters locations can be co-nominated. Each chapter will receive credit to submit a PACE nomination. All chapters must be identified on the nomination form and before the nominations are judged. _________________________________________________ Name _________________________________________________ Title _________________________________________________ Agency/Organization _________________________________________________ Address (if post office box, include street address) __________________________________________ City Community relations-a summary of the efforts by the agency, consultant and contractor to protect public lives and property, minimize public inconvenience and improve relations. Unusual accomplishments under adverse conditions, including but not limited to, adverse weather, soil or site conditions, or other occurrences over which there was no control. Additional considerations you would like to bring to the attention of the project review panel, such as innovations in technology and/or management applications during the project. NOTE: Supporting documentation is limited to 20 pages, exclusive of photographs and nomination form. Photographs will be used for promotional purposes by the association. Submittal should include nomination form and supporting documentation form, and photographs. No letters of recommendation please. Simultaneous nomination of the same project in both Public Works Project of the Year and SC/RC Project of the Year or in two categories is not permitted. Nominations not chosen in a specific year for the Public Works Project of the Year-Small Cities/Rural Communities Award cannot be resubmitted in a subsequent year in the other category. Zip/Postal Code __________________________________________ Phone State/Province Fax __________________________________________ E-mail